nach oben

European Journal of Nuclear Medicine and Molecular Imaging

Erschienen in:

05.12.2015 | Original Article

Prospective comparison of ⁶⁸Ga-DOTATATE and ¹⁸F-FDOPA PET/CT in patients with various pheochromocytomas and paragangliomas with emphasis on sporadic cases

verfasst von: Aurélien Archier, Arthur Varoquaux, Philippe Garrigue, Marion Montava, Carole Guerin, Sophie Gabriel, Eva Beschmout, Isabelle Morange, Nicolas Fakhry, Frédéric Castinetti, Frédéric Sebag, Anne Barlier, Anderson Loundou, Benjamin Guillet, Karel Pacak, David Taïeb

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 7/2016

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Pheochromocytomas/paragangliomas (PHEOs/PGLs) overexpress somatostatin receptors and recent studies have already shown excellent results in the localization of these tumors using ⁶⁸Ga-labeled somatostatin analogs (⁶⁸Ga-DOTA-SSA), especially in patients with germline succinate dehydrogenase subunit B gene (SDHB) mutations and head and neck PGLs (HNPGLs). The value of ⁶⁸Ga-DOTA-SSA has to be established in sporadic cases, including PHEOs. Thus, the aim of this study was to compare ⁶⁸Ga-DOTATATE PET/CT, ¹⁸F-FDOPA PET/CT, and conventional imaging in patients with various PHEOs/PGLs with a special emphasis on sporadic cases, including those located in the adrenal gland.

Design

⁶⁸Ga-DOTATATE, ¹⁸F-FDOPA PET/CT, and conventional imaging (contrast-enhanced CT and MRI with MR angiography sequences) were prospectively performed in 30 patients (8 with SDHD mutations, 1 with a MAX mutation and 21 sporadic cases) with PHEO/PGL at initial diagnosis or relapse.

Results

The patient-based sensitivities were 93 % (28/30), 97 % (29/30), and 93 % (28/30) for ⁶⁸Ga-DOTATATE PET/CT, ¹⁸F-FDOPA PET/CT, and conventional imaging, respectively. The lesion-based sensitivities were 93 % (43/46), 89 % (41/46), and 76 % (35/46) for ⁶⁸Ga-DOTATATE PET/CT, ¹⁸F-FDOPA PET/CT, and conventional imaging respectively (p = 0.042). ⁶⁸Ga-DOTATATE PET/CT detected a higher number of HNPGLs (30/30) than ¹⁸F-FDOPA PET/CT (26/30; p = 0.112) and conventional imaging (24/30; p = 0.024). ⁶⁸Ga-DOTATATE PET/CT missed two PHEOs of a few millimeters in size and a large recurrent PHEO. One lesion was considered false-positive on ⁶⁸Ga-DOTATATE PET/CT and corresponded to a typical focal lesion of fibrous dysplasia on MRI. Among the 11 lesions missed by conventional imaging, 7 were detected by conventional imaging with knowledge of the PET results (4 HNPGLs, 2 LNs, and 1 recurrent PHEO).

Conclusion

⁶⁸Ga-DOTATATE PET/CT is the most sensitive tool in the detection of HNPGLs, especially SDHD-related tumors, which may be very small and fail to concentrate sufficient ¹⁸F-FDOPA. The present study further expands the use of ⁶⁸Ga-DOTATATE for all patients with HNPGLs, regardless of their genotype. ⁶⁸Ga-DOTATATE PET/CT may be inferior to ¹⁸F-FDOPA PET/CT in the detection PHEOs.

Nur mit Berechtigung zugänglich

Castinetti F, Kroiss A, Kumar R, Pacak K, Taieb D. 15 years of paraganglioma: imaging and imaging-based treatment of pheochromocytoma and paraganglioma. Endocr Relat Cancer. 2015;22:T135–45. doi:10.1530/ERC-15-0175.CrossRefPubMed

Taieb D, Hicks RJ, Pacak K. Radiopharmaceuticals in paraganglioma imaging: too many members on board? Eur J Nucl Med Mol Imaging. 2015. doi:10.1007/s00259-015-3213-4.PubMedCentral

Taieb D, Kaliski A, Boedeker CC, Martucci V, Fojo T, Adler Jr JR, et al. Current approaches and recent developments in the management of head and neck paragangliomas. Endocr Rev. 2014;35:795–819. doi:10.1210/er.2014-1026.CrossRefPubMedPubMedCentral

van den Berg R, Schepers A, de Bruine FT, Liauw L, Mertens BJ, van der Mey AG, et al. The value of MR angiography techniques in the detection of head and neck paragangliomas. Eur J Radiol. 2004;52:240–5. doi:10.1016/j.ejrad.2003.12.002.CrossRefPubMed

Neves F, Huwart L, Jourdan G, Reizine D, Herman P, Vicaut E, et al. Head and neck paragangliomas: value of contrast-enhanced 3D MR angiography. AJNR Am J Neuroradiol. 2008;29:883–9. doi:10.3174/ajnr.A0948.CrossRefPubMed

Gravel G, Niccoli P, Rohmer V, Moulin G, Borson-Chazot F, Rousset P, et al. The value of a rapid contrast-enhanced angio-MRI protocol in the detection of head and neck paragangliomas in SDHx mutations carriers: a retrospective study on behalf of the PGL.EVA investigators. Eur Radiol. 2015. doi:10.1007/s00330-015-4024-5.PubMed

Naji M, Al-Nahhas A. (68)Ga-labelled peptides in the management of neuroectodermal tumours. Eur J Nucl Med Mol Imaging. 2012;39 Suppl 1:61–7. doi:10.1007/s00259-011-1990-y.CrossRef

Naji M, Zhao C, Welsh SJ, Meades R, Win Z, Ferrarese A, et al. 68Ga-DOTA-TATE PET vs. 123I-MIBG in identifying malignant neural crest tumours. Mol Imaging Biol. 2011;13:769–75. doi:10.1007/s11307-010-0396-8.CrossRefPubMed

Sharma P, Thakar A, Suman Kc S, Dhull VS, Singh H, Naswa N, et al. 68Ga-DOTANOC PET/CT for baseline evaluation of patients with head and neck paraganglioma. J Nucl Med. 2013;54:841–7. doi:10.2967/jnumed.112.115485.CrossRefPubMed

10.

Kroiss A, Shulkin BL, Uprimny C, Frech A, Gasser RW, Url C, et al. (68)Ga-DOTATOC PET/CT provides accurate tumour extent in patients with extraadrenal paraganglioma compared to (123)I-MIBG SPECT/CT. Eur J Nucl Med Mol Imaging. 2015;42:33–41. doi:10.1007/s00259-014-2892-6.CrossRefPubMed

11.

Sharma P, Mukherjee A, Karunanithi S, Naswa N, Kumar R, Ammini AC, et al. Accuracy of 68Ga DOTANOC PET/CT imaging in patients with multiple endocrine neoplasia syndromes. Clin Nucl Med. 2015;40:e351–6. doi:10.1097/RLU.0000000000000775.CrossRefPubMed

12.

Hofman MS, Lau WF, Hicks RJ. Somatostatin receptor imaging with 68Ga DOTATATE PET/CT: clinical utility, normal patterns, pearls, and pitfalls in interpretation. Radiographics. 2015;35:500–16. doi:10.1148/rg.352140164.CrossRefPubMed

13.

Kroiss A, Putzer D, Frech A, Decristoforo C, Uprimny C, Gasser RW, et al. A retrospective comparison between (68)Ga-DOTA-TOC PET/CT and (18)F-DOPA PET/CT in patients with extra-adrenal paraganglioma. Eur J Nucl Med Mol Imaging. 2013;40:1800–8. doi:10.1007/s00259-013-2548-y.CrossRefPubMed

14.

Janssen I, Blanchet EM, Adams K, Chen CC, Millo CM, Herscovitch P, et al. Superiority of [68Ga]-DOTATATE PET/CT to other functional imaging modalities in the localization of SDHB-associated metastatic pheochromocytoma and paraganglioma. Clin Cancer Res. 2015;21:3888–95. doi:10.1158/1078-0432.CCR-14-2751.CrossRefPubMed

15.

Janssen I, Chen CC, Taieb D, Patronas NJ, Millo CM, Adams KT, et al. 68Ga-DOTATATE PET/CT in the localization of head and neck paragangliomas compared to other functional imaging modalities and CT/MRI. J Nucl Med. 2015. doi:10.2967/jnumed.115.161018.PubMedCentral

16.

Charrier N, Deveze A, Fakhry N, Sebag F, Morange I, Gaborit B, et al. Comparison of [111In]pentetreotide-SPECT and [18F]FDOPA-PET in the localization of extra-adrenal paragangliomas: the case for a patient-tailored use of nuclear imaging modalities. Clin Endocrinol. 2011;74:21–9. doi:10.1111/j.1365-2265.2010.03893.x.CrossRef

17.

King KS, Chen CC, Alexopoulos DK, Whatley MA, Reynolds JC, Patronas N, et al. Functional imaging of SDHx-related head and neck paragangliomas: comparison of 18F-fluorodihydroxyphenylalanine, 18F-fluorodopamine, 18F-fluoro-2-deoxy-D-glucose PET, 123I-metaiodobenzylguanidine scintigraphy, and 111In-pentetreotide scintigraphy. J Clin Endocrinol Metab. 2011;96:2779–85. doi:10.1210/jc.2011-0333.CrossRefPubMedPubMedCentral

18.

Gabriel S, Blanchet EM, Sebag F, Chen CC, Fakhry N, Deveze A, et al. Functional characterization of nonmetastatic paraganglioma and pheochromocytoma by (18)F-FDOPA PET: focus on missed lesions. Clin Endocrinol. 2013;79:170–7. doi:10.1111/cen.12126.CrossRef

19.

Chen CC, Czerwiec FS, Feuillan PP. Visualization of fibrous dysplasia during somatostatin receptor scintigraphy. J Nucl Med. 1998;39:238–40.PubMed

20.

Agrawal K, Bhadada S, Mittal BR, Shukla J, Sood A, Bhattacharya A, et al. Comparison of 18F-FDG and 68Ga DOTATATE PET/CT in localization of tumor causing oncogenic osteomalacia. Clin Nucl Med. 2015;40:e6–10. doi:10.1097/RLU.0000000000000460.CrossRefPubMed

21.

Breer S, Brunkhorst T, Beil FT, Peldschus K, Heiland M, Klutmann S, et al. 68Ga DOTA-TATE PET/CT allows tumor localization in patients with tumor-induced osteomalacia but negative 111In-octreotide SPECT/CT. Bone. 2014;64:222–7. doi:10.1016/j.bone.2014.04.016.CrossRefPubMed

22.

Fottner C, Helisch A, Anlauf M, Rossmann H, Musholt TJ, Kreft A, et al. 6-18F-fluoro-L-dihydroxyphenylalanine positron emission tomography is superior to 123I-metaiodobenzyl-guanidine scintigraphy in the detection of extraadrenal and hereditary pheochromocytomas and paragangliomas: correlation with vesicular monoamine transporter expression. J Clin Endocrinol Metab. 2010;95:2800–10.CrossRefPubMed

23.

Fiebrich HB, Brouwers AH, Kerstens MN, Pijl ME, Kema IP, de Jong JR, et al. 6-[F-18]Fluoro-L-dihydroxyphenylalanine positron emission tomography is superior to conventional imaging with (123)I-metaiodobenzylguanidine scintigraphy, computer tomography, and magnetic resonance imaging in localizing tumors causing catecholamine excess. J Clin Endocrinol Metab. 2009;94:3922–30.CrossRefPubMed

24.

Letouze E, Martinelli C, Loriot C, Burnichon N, Abermil N, Ottolenghi C, et al. SDH mutations establish a hypermethylator phenotype in paraganglioma. Cancer Cell. 2013;23:739–52. doi:10.1016/j.ccr.2013.04.018.CrossRefPubMed

25.

Saveanu A, Muresan M, De Micco C, Taieb D, Germanetti AL, Sebag F, et al. Expression of somatostatin receptors, dopamine D(2) receptors, noradrenaline transporters, and vesicular monoamine transporters in 52 pheochromocytomas and paragangliomas. Endocr Relat Cancer. 2011;18:287–300. doi:10.1530/ERC-10-0175.CrossRefPubMed

26.

Kroiss A, Putzer D, Decristoforo C, Uprimny C, Warwitz B, Nilica B, et al. 68Ga-DOTA-TOC uptake in neuroendocrine tumour and healthy tissue: differentiation of physiological uptake and pathological processes in PET/CT. Eur J Nucl Med Mol Imaging. 2013;40:514–23. doi:10.1007/s00259-012-2309-3.CrossRefPubMed

27.

Huang YT, Aziz SI, Ravi Kumar AS. Gallium-68 DOTA-TATE positron emission tomography/computed tomography: scintigraphic changes of adrenal glands following management of ectopic Cushing's syndrome by steroidogenesis inhibitors. World J Nucl Med. 2014;13:201–4. doi:10.4103/1450-1147.144823.CrossRefPubMedPubMedCentral

28.

Varoquaux A, le Fur Y, Imperiale A, Reyre A, Montava M, Fakhry N, et al. Magnetic resonance spectroscopy of paragangliomas: new insights into in vivo metabolomics. Endocr Relat Cancer. 2015;22:M1–8. doi:10.1530/ERC-15-0246.CrossRefPubMedPubMedCentral

29.

Blanchet EM, Millo C, Martucci V, Maass-Moreno R, Bluemke DA, Pacak K. Integrated whole-body PET/MRI with 18F-FDG, 18F-FDOPA, and 18F-FDA in paragangliomas in comparison with PET/CT: NIH first clinical experience with a single-injection, dual-modality imaging protocol. Clin Nucl Med. 2014;39:243–50. doi:10.1097/RLU.0000000000000289.CrossRefPubMed

30.

Hofman MS, Hicks RJ. Moving beyond "lumpology": PET/CT imaging of pheochromocytoma and paraganglioma. Clin Cancer Res. 2015;21:3815–7. doi:10.1158/1078-0432.CCR-15-1073.CrossRefPubMed

Titel: Prospective comparison of 68Ga-DOTATATE and 18F-FDOPA PET/CT in patients with various pheochromocytomas and paragangliomas with emphasis on sporadic cases
verfasst von: Aurélien Archier
Arthur Varoquaux
Philippe Garrigue
Marion Montava
Carole Guerin
Sophie Gabriel
Eva Beschmout
Isabelle Morange
Nicolas Fakhry
Frédéric Castinetti
Frédéric Sebag
Anne Barlier
Anderson Loundou
Benjamin Guillet
Karel Pacak
David Taïeb
Publikationsdatum: 05.12.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 7/2016
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-015-3268-2

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Prospective comparison of ⁶⁸Ga-DOTATATE and ¹⁸F-FDOPA PET/CT in patients with various pheochromocytomas and paragangliomas with emphasis on sporadic cases

Abstract

Purpose

Design

Results

Conclusion

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Purpose

Design

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 7/2016

Nami Azar and Carolyn K. Donaldson (Eds): RadCases. Ultrasound Imaging. Thieme Publishers New York 2015, ISBN: 978-1-60406322-6

Cumali Aktolun and Stanley J. Goldsmith (Eds): Nuclear Oncology

Evaluation of 68Ga-DOTA-TOC PET/CT for the detection of duodenopancreatic neuroendocrine tumors in patients with MEN1

Cholinergic imaging in dementia spectrum disorders

Reduction in camera-specific variability in [123I]FP-CIT SPECT outcome measures by image reconstruction optimized for multisite settings: impact on age-dependence of the specific binding ratio in the ENC-DAT database of healthy controls

Erratum to: Vesicular monoamine transporter protein expression correlates with clinical features, tumor biology, and MIBG avidity in neuroblastoma: a report from the Children’s Oncology Group